Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MORALS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 883 records · Page 49Linked to original sources
PubMed2002

Traversing boundaries: clinical ethics, moral experience, and the withdrawal of life supports.

While many have suggested that to withdraw medical interventions is ethically equivalent to withholding them, the moral complexity of actually withdrawing life supportive interventions from a patient cannot be ignored. Utilizing interplay between expository and narrative styles, and drawing upon our experiences with patients, families, nurses, and physicians when life supports have been withdrawn, we explore the changeable character of "boundaries" in end-of-life situations. We consider ways in which boundaries imply differences--for example, between cognition and performance--and how the encounter with boundaries can generate altered meanings important for understanding decisions and actions in these contexts. We conclude that the reliance on mere roles to support the moral weight of withdrawing medical interventions is inadequate. Roles that lead us to such moments are exceeded by the responsibility encountered in such moments. And here, we suggest, is the momentous character of withdrawal: it presents the grave astonishment, the trembling awe, in the "not-being-there" of the other in death.

Ethicists↗
PubMed2002

Parental responsibility and the morality of selective abortion.

It is now a common opinion in Western countries that a child's impairment would probably place an unexpected burden on her parents, a burden that the parents have not committed themselves to dealing with. Therefore, selective abortion is in general a morally justified option for the parents. I argue that this view is based on biased information about the quality of life of individuals with impairments and their families. Also, a conscious decision to procreate should bring about conscious assent to assuming obligations as a parent. This implies a duty of caring for any kind of child. Consequently, if the child's condition is not such that it would make its life not worth living, and if the parents live in an environment where they are not able to provide their child and themselves an adequate well-being, they do not have a morally sufficient reason to terminate the pregnancy on the grounds of fetal abnormality.

Abortion, Eugenic↗
PubMed2003

[Improving work morale of nurses despite insurance cost cutting. 2. Program planning].

Declining resources in health care frequently translate into work overload and declining opportunities for nursing staff. Faced with increases in absenteeism and lower morale among staff, nursing administrators must develop low-cost approaches to these problems. Building on the assessment process in Part 1, the authors present elements of program planning, illustrating the process with a low-cost model program to improve morale that addresses workload, learning opportunities, and organizational rewards for staff nurses.

Cost Control↗
PubMed1999

Generativity and moral development as predictors of value-socialization narratives for young persons across the adult life span: from lessons learned to stories shared.

Little research so far has examined storytelling as a channel of value socialization. In the present study, 129 adults from 3 age groups (18-26, 28-50, 60-75) were asked to tell stories for adolescents about 2 of their past value-learning experiences. Generative concern (D. P. McAdams & E. de St. Aubin, 1992) and moral reasoning stage level were also assessed. Stronger generative concern was predictive of a greater sense of having learned important lessons from these past events, of stronger adult value socialization investment, and of more engaging narratives for adolescents as judged by a panel of uninstructed raters. Higher levels of moral reasoning were positively related to generative concern and to a stronger sense of past lessons learned. Generativity appears important to the project of value socialization across the adult life span.

Adult↗
PubMed2001

The consolidation/transition model in moral reasoning development.

The consolidation/transition model conceptualizes development as entailing a cyclical pattern of alternating consolidation and transition phases and posits that stage advance is predicted by a specific distribution of reasoning across stages indicative of disequilibrium (more reasoning above than below the mode, with a high degree of mixture). The validity of this model was examined in the context of moral reasoning development with the use of standard statistical techniques as well as Bayesian techniques that can better account for classification error. In this longitudinal study. 64 children and adolescents participated in 5 annual administrations of the Moral Judgment Interview. The distribution of their reasoning across stages was used to predict subsequent development. The results support the hypotheses regarding cyclical patterns of change and predictors of stage transition and demonstrate the utility of Bayesian techniques for evaluating developmental change.

Adolescent↗
PubMed2006

Contemplation of moral dilemmas eliminates sex differences on the Iowa gambling task.

Men outperform women on the Iowa Gambling Task (IGT; A. Bechara, H. Damasio, D. Tranel, & A. R. Damasio, 1997). In this study, the authors show that sex differences are not due to differences in general emotional arousal or the abilities to calculate or reverse responses. Imaging studies have shown that, during the IGT, men increase activity in the right dorsolateral prefrontal cortex (PFC) and lateral orbital PFC, whereas women increase activity in the left medial orbital PFC. Deliberation of personal moral (PM) dilemmas also increases activity in medial and lateral dorsal PFC, whereas deliberation of moral impersonal (MI) dilemmas increases activity in lateral dorsal PFC. In the present study, men and women performed the IGT during PM, MI, or control deliberations. Deliberation of only PM dilemmas increased women's IGT performance to the level of men.

Adolescent↗
PubMed2000

Promoting tolerance and moral engagement through peer modeling.

Behavioral journalism influences audiences by presenting peer modeling for cognitive processes that lead to behavior change. This technique was used in student newsletters promoting intergroup tolerance and moral engagement in a Houston high school with a diverse ethnic composition. Pretest (N = 393) and posttest (N = 363) cross-sectional comparisons of the student population in that school provided evidence of short-term (6 month) communication effects on attitudes and behavior. Tolerance and moral engagement increased among students in the school where behavioral journalism newsletters were distributed, and there was a corresponding reduction in hostile behavioral intentions and in reports of verbal aggression.

Adolescent↗
PubMed1999

Impairment of social and moral behavior related to early damage in human prefrontal cortex.

The long-term consequences of early prefrontal cortex lesions occurring before 16 months were investigated in two adults. As is the case when such damage occurs in adulthood, the two early-onset patients had severely impaired social behavior despite normal basic cognitive abilities, and showed insensitivity to future consequences of decisions, defective autonomic responses to punishment contingencies and failure to respond to behavioral interventions. Unlike adult-onset patients, however, the two patients had defective social and moral reasoning, suggesting that the acquisition of complex social conventions and moral rules had been impaired. Thus early-onset prefrontal damage resulted in a syndrome resembling psychopathy.

Adult↗
PubMed2001

The effects of unit morale and interpersonal relations on conflict in the nursing unit.

BACKGROUND: Health care organizations face major changes, and these changes are likely to increase conflict in organizations. Although numerous studies have focused on conflict management, few have considered causes and effect of conflict in nursing units. METHODS: The investigation tested a structural equation that examined the relationships among individual and contextual variables and intragroup conflict, job satisfaction, team performance effectiveness, and anticipated turnover. The nonrandom sample consisted of 141 nurses employed on 13 inpatient units at a state-supported, 597-bed academic medical centre in a southeastern city. RESULTS: Intragroup conflict was higher on smaller units with a higher ratio of RNs to total staff. Intragroup conflict was not associated with satisfaction with pay or anticipated turnover. In the final model, the unit morale and interpersonal relations dimension of team performance effectiveness was negatively associated with intragroup conflict and anticipated turnover, and positively associated with satisfaction with pay. High perceptions of unit morale and interpersonal relations buffered the effect of unit size and skill mix on intragroup conflict. Goodness of fit statistics indicated a good fit of the model to data. CONCLUSION: The findings have implications for nursing educators and administrators, and provide direction for future research.

Academic Medical Centers↗
PubMed2002

Caring as a slave morality: Nietzschean themes in nursing ethics.

BACKGROUND: Sceptical arguments about 'caring' can be divided into three categories. First, it is suggested that, while caring is no doubt an admirable thing in itself, it is just one ideal among others. Secondly, it is claimed that caring is not really a virtue at all, and that it should be regarded as more of a vice, because it promotes favouritism, injustice, and self-deception. Thirdly, there is a worry that caring is not politically realistic, and that its advocates underestimate the powerful organizational and social structures which conspire to subvert nursing. AIM: This paper outlines a fourth, and more radical, type of scepticism, which explains why caring is subject to these drawbacks. In doing so, it considers the relation between caring, phenomenology and holism in nursing discourse, and the way in which all three fit together to form the 'caring paradigm'. METHODS: The paper adopts a genealogical approach, borrowed directly from Nietzsche's Genealogy of Morality. That book argues that the values associated with caring are the expression of a profound resentment, harboured by the slaves (weak, powerless, timorous) against the nobles (strong, powerful, self-confident). Caring represents an inversion, a sort of 'fantasy revenge', in which the nobles can be portrayed as 'evil', while the slaves portray their own weakness as 'good'. Taking its cue from Nietzsche, the paper shows that the Genealogy narrative can be transposed into a modern health care context, with nurses as the 'slaves' and the medical profession as the 'nobles'. CONCLUSIONS: The ideology of caring is, in the Genealogy's terms, a slave morality. It represents an attack on the 'medical-scientific model', motivated by resentment, and designed to establish nursing's superiority. Its effects have been debilitating, and it has prevented nursing from becoming a 'noble' (that is, a properly scientific) discipline.

Christianity↗
PubMed2003

Staff morale in the merger of mental health and social care organizations in England.

Following the closure of the last Victorian asylum in Somerset, the health authority and county council undertook a review of mental health services. A major outcome of this review was the creation of an integrated mental health and social care provider. The current paper explores the impact of this integration on the morale of staff members involved, using a conceptual model derived from the literature on organizational behaviour. During the year immediately following integration, the average ratings on all measures of role clarity and job satisfaction reduced. For staff members involved in the integration, by far the largest group of whom were mental health nurses, job satisfaction was related to team role clarity, team identification, emotional exhaustion and gender. These effects of the integration on staff morale are discussed in light of the wider research into the determinants of job satisfaction and the conditions for success in merging organizations. The study has significant implications for managerial and professional leadership during organizational change.

Attitude of Health Personnel↗
PubMed2003

Moral responsibility and borderline personality disorder.

OBJECTIVE: To examine the concepts of free will and moral responsibility in a psychiatric context, and to consider whether those with borderline personality disorder (BPD) may be considered responsible for their actions. METHOD: A wide, but necessarily incomplete, range of literature was reviewed in the fields of psychiatry and philosophy. I offer a set of criteria for responsible action and examine some features of BPD in the light of these criteria. RESULTS: Impulsivity, acting out and the less severe forms of dissociation do not vitiate responsibility. Severe dissociative and psychotic symptoms may well render people with BPD less morally responsible for their actions. CONCLUSIONS: Comorbid conditions in BPD may also affect the ability to act responsibly.

Borderline Personality Disorder↗
PubMed2001

Empowering moral decision making in nurses.

In the past years a schooling programme in moral decision making has been provided in an Amsterdam acute care hospital for health care professionals. The goal has been to heighten awareness, stimulate communication between disciplines regarding moral dilemmas and support members of different disciplines to reach commonly shared decisions. This article discusses the outcomes of the schooling programme and shows that an investment of this type improves communication amongst disciplines and contributes towards the empowerment of nurses.

Decision Making↗
PubMed2003

Morality, ethics, and law: introductory concepts.

The purpose of this article is to differentiate morality, ethics, and law. Morality refers to a set of deeply held, widely shared, and relatively stable values within a community. Ethics as a philosophical enterprise involves the study of values, and the justification for right and good actions, as represented by the classic works of Aristotle (virtue ethics), Kant (duty-based ethics), and Bentham and Mill (utilitarian and consequentialist ethics). Applied ethics, in contrast, is the use of ethics principles (e.g., respect for autonomy, beneficence, and nonmaleficence, justice) in actual situations, such as in professional and clinical life. Finally, law is comprised of concrete duties established by governments that are necessary for maintaining social order and resolving disputes, as well as for distributing social resources according to what people need or deserve.

Ethical Theory↗
PubMed1983

The care of the terminally ill: morality and economics.

Are current expenditures on dying patients disproportionate, unreasonable, or unjust? Although a review of empirical data reveals that care for the terminally ill is very costly, it is not appropriate to conclude that such expenditures represent a morally troubling misallocation of societal resources. Moreover, though efforts to reduce the costs of caring for the dying are not unreasonable, they must be undertaken with great caution. At present, such efforts should concentrate on three basic goals: development of better criteria for admission to intensive- and critical-care units; promotion of patient and family autonomy with regard to decisions to stop or refuse certain kinds of treatment; and promotion of alternative forms of institutional care, such as hospice care. The most difficult moral problems will arise when patients and their physicians seek access to therapies judged only marginally useful. There may be conflict between administrators with broad institutional responsibilities and clinicians committed to particular patients.

Cost-Benefit Analysis↗
PubMed1984

When is termination of pregnancy during the third trimester morally justifiable?

The question whether to terminate pregnancy during the third trimester involves a moral conflict. We argue that such termination is morally justifiable if two conditions are fulfilled: first, that the fetus is afflicted with a condition that is either incompatible with postnatal survival for more than a few weeks or characterized by the total or virtual absence of cognitive function; and second, that highly reliable diagnostic procedures are available for determining prenatally that the fetus fulfills either of the two parts of the first condition. At present, one entity, anencephaly, clearly fulfills both conditions. We studied 10 cases involving fetuses with sonographically diagnosed anencephaly that were aborted during the third trimester. We also examined other fetal disorders and conclude that they do not clearly fulfill our two conditions for the justifiable termination of pregnancy in the third trimester.

Abortion, Induced↗
PubMed2002

Animal research, non-vegetarianism, and the moral status of animals--understanding the impasse of the animal rights problem.

I offer some reasons for the theory that, compared with human beings, non-human animals have some but lesser intrinsic value. On the basis of this theory, I first argue that we do not know how to compare an animal's claim to be free from a more serious type of harm (e.g., death), and a human's claim to be free from some lesser type of harm (e.g., non-fatal morbidity). For we need to take account of these parties' intrinsic value, and their competing types of claim. Yet, there exists no known way for making such comparison, when a human's intrinsic value is higher than that of an animal, whereas the type of claim an animal has is morally weightier than the type of claim a human has. Second, I explain why utilitarianism is unhelpful in making such comparison. Third, in the case where some animals can be sacrificed for saving a larger number of humans, it is crucial to ask whether animals have the right to life, and I argue that this question is more perplexing than we might think. My conclusion is that the various difficulties mentioned above have a deeper source than we have so far acknowledged, and that this reflects that the moral reality is less tidy and more complex than many theories portray.

Animal Experimentation↗
PubMed2004

Sexual-moral attitudes, love styles, and mate selection.

Students at a southwestern university were surveyed to test the interrelations of three constructs: sexual-moral attitudes, love styles, and attraction criteria. Following the procedures of the National Health and Social Life Survey, from which the sexual-moral attitude items were obtained, we conducted a cluster analysis to create attitudinal groupings. We obtained four clusters representing various nuances of liberalism and conservatism. When compared on love styles, the clusters differed primarily on ludus and pragma. Not only did some of the liberal clusters differ from some of the conservative ones on love styles, but there were also some differences within liberalism and within conservatism. Cluster differences also emerged on the attraction criteria.

Adult↗